Complex Care Programs and Services
Intensive Post-Acute Rehabilitation
Individuals entering rehabilitation are always unique, but their primary objective is typically the same – a return to health, home and what’s important in life, as soon as possible. At Touchpoints Rehab, part of the iCare Health Network, we understand.
Our innovative, personalized program is designed to accelerate the recovery process, so that patients can Get Well, Live Well and Be Well, faster, better and with fewer challenges than any traditional rehabilitation program. These programs are designed to optimize therapy, promote recovery, and provide ongoing quality of life for patients experiencing chronic and high acuity medical conditions.
What is Complex Care?
Touchpoints Rehab is a leader in this field. The Complex Care program uses a team of healthcare providers including nursing, respiratory and other staff to closely monitor a patient’s health status and facilitate safe transitions from setting to setting. This team will guide care from the hospital to the skilled nursing facility and into the home ensuring a smooth transition from one to the next. You will often see the same nurse or team member in the hospital, in the facility and following up after discharge to ensure success and avoid readmission to the hospital.
The Complex Care team works with physician guidance and alongside APRNs, Physician’s Assistants and the entire staff of the skilled nursing facility. The team focuses additional focus and resources on patients with complicated medical conditions who are at risk for frequent hospital admission.
Complex Care Team
- Transitional Care - Heart Failure Nurse
- Regional Clinical Director
- Care Transitions Respiratory Therapist
- Multi-disciplinary clinical team
- Consulting physician specialists, pulmonologists, PAs and APRNs
Addressing Frequent Hospitalizations
The program also addresses repeat hospitalizations by applying frequent lab work and assessment, integrated specialty care including pulmonary/respiratory therapy and sleep medicine, specialist consultation, clinical partnerships and more.
For patients with multiple hospitalizations the team will address their general state of health and wellness and improve their daily functionality. This will get them back home where they want to be and slow the tide of re-hospitalizations.
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Complex Care Clinical Programs
- Congestive Heart Failure
- Chronic Obstructive Pumonary Disease (COPD) and other related pulmonary disease processes.
- Post open-heart surgery care.
- Affiliation or enrollment in Accountable Care Organization, Risk or Payment Bundle and/or at high risk for readmission.
Program Highlights
Some patients who have been hospitalized following these conditions may be encouraged to stay in a post-acute facility to regain their strength. Our network partnerships ensure that our patients receive rehabilitation services in close collaboration with their medical team within the hospital networks. The key features of this unique approach include:
- The Touchpoints Rehab team has been trained by the hospital network team. The clinical team follows their established protocols.
- Touchpoints Rehab has experienced physicians and physician extenders.
- The Touchpoints Rehab team includes a dedicated Transitional Care Nurse who follows caseload patients through the course of their care, including after discharge home and provides additional, continuous clinical over- sight and support.
- The hospital and Touchpoints Rehab teams remain in continuous communication, working together to ensure a smooth transition.
- The hospital team remains informed on the progress of patients’ post-acute stays on a daily basis and continuing through discharge home.
- Once discharged, patients are reconnected with their primary care provider.
- Touchpoints Rehab staff are skilled in the delivery of all IV treatments and modalities.
Program Benefits
- Consultations and daily communication with the hospital team ensure continuity of care and optimal treatment decisions.
- Careful oversight of progress and a quieter, more personal environment are highly conducive to rapid improvements.
- Individually paced rehab programming enables faster recovery, stabilization and restoration of strength.
- Ongoing specialty evaluations
- Diagnosis-specific education for you and your family
- Healthy menus tailored to your diagnosis.
- Weight monitoring
- Physical, occupational and speech therapies
- Customized care planning
- Home support and discharge planning
- Weekly rounds by hospital practitioners
- IV Lasix, Bumex, Dobutamine and Milrinone therapies
- Weekly lab value monitoring
- Touchpoints Rehab locations in Bloomfield, Manchester, East Windsor and Farmington.
For more information, please call (860) 812-0788, email moc.nheraci@ofni or visit us online at www.touchpointsrehab.com
News & Updates
Discover the latest from our blog
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In recognition of National Wear Red Day, staff and residents proudly participated in the American Heart Association’s Go Red for Women movement, coming together in a sea of red to raise awareness about cardiovascular disease in women. While Touchpoints at Bloomfield’s commitment to cardiac care has been well documented—most recently through its certification by the American Heart Association—events like Wear Red Day demonstrate that heart health extends beyond clinical programs. It liv… -
MissionCare at Holyoke Marks Five Years of Purpose-Driven Care
February 5, 2026
Over the past five years, MissionCare at Holyoke has developed expertise in caring for individuals whose clinical and psychosocial needs require a higher level of coordination and support. The center welcomes residents from across Massachusetts, including those living with complex medical conditions and behavioral health diagnoses, as well as individuals connected to state agencies. Many arrive after experiencing barriers to placement elsewhere. MissionCare’s approach is to assess each referra… -
Touchpoints at Bloomfield Earns CMS Five-Star Rating, Adding to National Quality Distinctions
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Touchpoints at Bloomfield has achieved a significant milestone in quality and performance, earning a Five-Star Overall Rating from the Centers for Medicare & Medicaid Services (CMS). The Five-Star Quality Rating System is the federal government’s benchmark for nursing home quality, evaluating facilities based on health inspections, staffing levels, and clinical quality measures. For residents, families, and hospital partners, a Five-Star designation signals that a center is performing at t… -
At iCare Health Network, strong outcomes begin with strong systems of care. A recent Heart Failure Program success at Touchpoints at Chestnut reflects how consistent oversight and coordinated planning make a meaningful difference for medically complex residents. A 90-year-old resident with heart failure and atrial fibrillation was admitted for IV antibiotic treatment related to osteomyelitis, requiring a 45-day stay . Throughout his time at Touchpoints at Chestnut, he was supported under our str… -
Winter wellness is all about staying active, connected, and engaged in the community—and when we learned the East Windsor Senior Center has an active hiking group, it was an easy yes. Last week, Touchpoints at Chestnut Administrator Sarah Krebs, LNHA and Transitional Care CHF Nurse Mirja Tupas, RN joined 20 local seniors for a three-mile walk at Dart Hill Linear Park. This wasn’t a heart health presentation. It was walking side by side as neighbors—sharing stories, experience, and a … -
Celebrating Activities Professionals Day 2026: Creativity & Enrichment in Every Moment
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Today we join in celebrating Activities Professionals Day, a special annual recognition of the dedicated Therapeutic Recreation, Life Enrichment, and Activities teams across iCare Health Network — the creative hearts behind so many meaningful, joyful, and wellness-focused experiences for our residents. Quality of life is shaped not just by clinical care, but by connection, engagement, laughter, and purpose. Our Activities Professionals bring these elements to life every day, curating programs … -
A Longstanding Presence on Main Street: The Evolving History of Touchpoints at Chestnut
January 21, 2026
On Main Street in the Warehouse Point section of East Windsor, one building has quietly mirrored the changing needs of its community for more than half a century. Known today as Touchpoints at Chestnut, the facility’s history stretches back to a time when caring for seniors looked very different. Public records and archival references indicate that by the early 1960s, the property was operating as D’Amore Rest Haven, a small rest home serving older adults in the neighborhood. Period adverti… -
Honoring Dr. Martin Luther King, Jr. — MLK Day 2026
January 19, 2026
On Martin Luther King, Jr. Day, let us pause not only to remember history, but to recommit ourselves to the everyday work of dignity: caring for people as whole human beings, listening with humility, and building trust across differences. This type of service isn’t an abstract idea—it’s measured in small, consistent actions: patience, respect, advocacy, and the belief that every life has equal worth. Dr. King’s words continue to challenge us to see our shared responsibility to one anothe…
